National Provider Identifier [NPI]: |
1154369726 |
Last Name Of The Provider |
CALVERT |
First Name Of The Provider |
EDWARD |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
503 MCMILLAN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST MONROE |
Zip Code Of The Provider |
712915327 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
856 |
Number Of Medicare Beneficiaries |
679 |
Total Submitted Charge Amount |
675059 |
Total Medicare Allowed Amount |
119126.3 |
Total Medicare Payment Amount |
91039.28 |
Total Medicare Standardized Payment Amount |
93930.88 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
24 |
Number Of Medical Services |
856 |
Number Of Medicare Beneficiaries With Medical Services |
679 |
Total Medical Submitted Charge Amount |
675059 |
Total Medical Medicare Allowed Amount |
119126.3 |
Total Medical Medicare Payment Amount |
91039.28 |
Total Medical Medicare Standardized Payment Amount |
93930.88 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
217 |
Number Of Beneficiaries Age 65 to 74 |
171 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
142 |
Number Of Female Beneficiaries |
397 |
Number Of Male Beneficiaries |
282 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
338 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
308 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
371 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0546 |